Is OBGYN for me?? Your honest opinions, please!

[sophiejane]

I'm a 3rd year who has been set on FP since day one. I was dreading my OBGYN rotation, in fact. Then, after the first 2 weeks, I really liked it, so I started thinking about maybe doing a fellowship....now, after 4 weeks, I am finding myself REALLY liking it to the point of possibly changing my mind and doing an OBGYN residency...

I have no idea where I stand in comparison to other applicants, if OBGYN is a pipe dream, or what.

I am at a DO school, top half of my class, 85 (208) on USMLE and about the same on COMLEX. No DO OBGYN programs in my state--but plenty of allopathic ones (TX). Need to stay central TX for family reasons. I hope to do better on Step 2, and am pretty sure I can.

I've had excellent evals all year, though mediocre shelf scores are keeping my grades in the 88-89 range for FM, IM, and surgery. I think I can get a really good letter from my OBGYN attending who is also the dept head. I've been studying hard for OBGYN so I think I can do well on the shelf.

What do you guys think? Should I just do FP with an OB fellowship and hope I can find a rural area to deliver some babies in? I love rural medicine and had always planned to do that, so that part doesn't bother me...I just wonder if I am liking this so much and will end up doing mostly OB in my FP practice anyway, if I shouldn't just go for the real deal...

I'm really torn. Bummed that my original plans are being put into question, but also really excited about the possibility of doing OBGYN....

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[tiredmom]

I worked as a L&D nurse at the ob site for the FP program back home before med school. In over 4 years, I knew 1 resident who was planning on doing ob care in real practice. He went to a tiny town that I can't pronounce. We had another who went back for an ob residency (not fellowship) after finishing his FP residency because he said that he likely wouldn't be able to get reasonable rates for malpractice insurance as a fellow'd FP (seems ridiculous to say reasonable rate and malpractice in the same sentence ) or find a place that he wasn't the only doc in 4 counties to practice. Nearly all the rest of the 40+ residents who rotated through, couldn't care less about ob. My opinion is, if you love ob, do ob. There is at least 1 DO in the intern class at UTHSC-San Antonio, but I know nothing about her stats. Good luck.

 

[Wednesday]

Hi SophieJane,

I think it's great that you're questioning your prior career path. In my opinion, everyone should do that, even if they just go right back to their original plan, at least they have really worked through why they want to go in that direction. This is a huge decision that shouldn't be taken lightly. That said, I think that MANY people are suprised by ob/gyn. In fact, most of the people I met on interviews (applicants AND faculty/residents) suprised themselves by loving and ultimately choosing ob/gyn. I think it's just a product of all the negative publicity the field gets and the fact that most people don't really know what an ob/gyn actually does (besides deliver babies, of course).

The question you need to ask yourself is, do you like gyn and do you like surgery? Ob is great, but you have to be willing to learn to operate too and if you don't really like it, you may be miserable. You should definitely do a 4th year elective (maybe in the aspect of the field that you don't like as much and see if you can stand it) and find a good mentor to talk to about this stuff. Do a 4th year elective in family med too and directly compare the two.

You'll figure it out. Just don't be scared to commit if it does end up being the field for you. When you find something good in life, you gotta go for it. Good luck!

 

[sophiejane]

Right, that's the problem. I love the surgery part. I love the primary care part. I love the endocrine part (I once entertained the idea of endocrinology). And I even really like the GYN part.

I don't know why its a problem, really. It may be what I'm meant to do, even though, like you said, it totally has taken me by surprise. Looking at vaginas all day and doing surgery are two things I NEVER thought I'd want to do. But now that I think I'd really like it, I guess I have some fear that I don't have the stats to be competitive, and I also don't know how "competitive" OBGYN residencies are.

One option I've considered is applying to a few FP programs with strong OB as a backup in addition to OBGYN programs. Will programs know that I've applied to both and think I'm not serious about either, or do they only see what is submitted to their program?

 

[neilc]

duplicate post, oops

 

[neilc]

One option I've considered is applying to a few FP programs with strong OB as a backup in addition to OBGYN programs. Will programs know that I've applied to both and think I'm not serious about either, or do they only see what is submitted to their program?

i did this...nobody will know if you don't tell them! however, i went on only one of the interviews to FP programs that i was offered...i like FP a lot, but i need to be in the OR on occasion. besides, i just don't think it is financially smart to do a 4 year FP residency (if you add in the 1 year ob fellowship) because you will make a LOT less than a ob/gyn for the same amount of training! but, i found i was getting so many more interviews than i expected that the FP backup was pretty unneccesary.

ob/gyn is not an "easy" match, but it is certainly within reach for most of us. there are a lot of programs out there, some tougher than others, but you will find a few that you love and that love you. true enthusiasm shows through the application and interview, and it is always well recieved. there is a lot more to matching than simply your step scores.

best of luck!

 

[fmdoc]

tiredmom,
I am a fmg doing fm residency and planning to reapply for ob/gyn residency...you mentioned a doctor who did the same...would you mind telling me if he was a amg or fmg? Thanks a lot. I would really appreciate your reply.

neilc
You mentioned that an ob/gyn physician makes a lot of money after graduation...although the financial aspect is not of importance to me, I am just curious to know the average salary that a fresh general ob/gyn graduate is making...Thanks a lot!

 

[Global Disrobal]

TO FM DOC:
Average Ob/GYN salary is dependent on many factors, and no "average" is a true indication of how much you "can" make coming out of residency. Factors that play into it are:
1. Region (Example: Midwest/Rural gives more money that saturated markets like Ca, DC, MD)
2. Academic versus Private
3. Small versus large group
4. Benefits/track/contract structure
5. Quality of your program/training
You'll make money in whatever specialty you choose. How much money will depend on your personality, life style desires, and career goals, therefore make your specialty selection based on the field.

As for the FMG/AMG status... don't stress it too much because one AMG's application differs from another and same goes for FMG's, as do other confounding factors. Bottomline is that FMG/AMG/IMG, whatever you want to call it can match into a residency if they are proactive and flexible enough. The question you'll have to answer will be WHY the switch, and providing ASSURANCE that you won't turn around and switch again after the first year of OB.

 

[tiredmom]

he is an amg... but i'm not sure it would matter much. he loved ob and put a lot of work into his rotations... much more than most of his fellow residents.

 

[neilc]

neilc
You mentioned that an ob/gyn physician makes a lot of money after graduation...although the financial aspect is not of importance to me, I am just curious to know the average salary that a fresh general ob/gyn graduate is making...Thanks a lot!

i never said they make a lot...just that if you do FP/OB it is a four year residency, and you make a lot less going that route than Ob/gyn.

as for averages, i have heard all different stories. but, i think it is safe to say 150K plus should be easy to find. to me, that is more than enough.

 

[sophiejane]

besides, i just don't think it is financially smart to do a 4 year FP residency (if you add in the 1 year ob fellowship) because you will make a LOT less than a ob/gyn for the same amount of training!

I am pretty sure the compensation for deliveries and procedures is the same whether you are boarded in FP or OBGYN. What makes the difference is volume of procedures.

A good rural FP who does a lot of procedures will make an easy $150K, and some I know are making quite a bit more than that.

The point for me is more that I want to be boarded in OB GYN if that is what I am doing the most of, and I don't relish the idea of 7 years of training to do both residencies.

I sort of feel like I am falling in love (with OBGYN) outside of an arranged marriage (FP)! We'll see where it goes....

Thanks for all your advice!

 

[neilc]

I am pretty sure the compensation for deliveries and procedures is the same whether you are boarded in FP or OBGYN. What makes the difference is volume of procedures.

A good rural FP who does a lot of procedures will make an easy $150K, and some I know are making quite a bit more than that.

i agree that it is possible to do well in FP. but, my point is more that in Ob/Gyn you have the opportunity to do primary care (FP, but just for women) coupled with a LOT more procedures that any FP is going to do, for the same amount of training. i don't see the benefit to doing FP + OB, unless you really want to take care of men and babies. if you want to deliver babies, it just seems to make more sense to do it via OB/GYn for a lot of reasons...ie, you will make more money, you will not be limited to where you can actually work and deliver babies, etc..

good luck!

 

[sophiejane]

i agree that it is possible to do well in FP. but, my point is more that in Ob/Gyn you have the opportunity to do primary care (FP, but just for women) coupled with a LOT more procedures that any FP is going to do, for the same amount of training. i don't see the benefit to doing FP + OB, unless you really want to take care of men and babies. if you want to deliver babies, it just seems to make more sense to do it via OB/GYn for a lot of reasons...ie, you will make more money, you will not be limited to where you can actually work and deliver babies, etc..

good luck!

That's very true. I didn't realize how much primary care there really was in the field until this rotation. Yet another bonus for OBGYN...

It just seems to be the best of all worlds, darnit!

(Can you tell I hate it when my well-laid plans start to be thrown into question?!)

The only thing I hesitate about is the lifestyle. I am obviously not one of these ER or anesthesia types who wants a "lifestyle" career, or I wouldn't be weighing FP vs OB...but I do see OBGYNs working really hard, taking lots of call, etc. I hope there is a way to find a happy medium--I'm sure there must be.

 

[fmdoc]

Thanks a lot tiredmom!

Thanks a lot neilc! neilc...I see that you compare the money that a general ob/gyn physician makes with the money that a fm+ob physician makes. I know it is not a hard rule, because of many variabilities involved, but how much of a difference in salary are we talking about between a gen ob/gyn and a fm+ob? Again, I am curious to see an approximate number...Thanks!

 

[sophiejane]

Thanks a lot tiredmom!

Thanks a lot neilc! neilc...I see that you compare the money that a general ob/gyn physician makes with the money that a fm+ob physician makes. I know it is not a hard rule, because of many variabilities involved, but how much of a difference in salary are we talking about between a gen ob/gyn and a fm+ob? Again, I am curious to see an approximate number...Thanks!

This is entirely a regional phenomenon. Liability insurance for OBs runs from $6000/yr in TN to $250K/yr in FLorida. FP liability is anywhere from 1/4 to 1/10 of that, but if you add in OB, it will approach that of OBGYNs. It also depends on how many deliveries you do, cost of living, overhead, reimbursement, insurance, demographics, what other procedures you might do as an FP, etc. etc....

Try salary.com--but even that will only give you a very rough estimate that will likely be in the $150-250K range for OBs--I doubt there are good numbers on FPs who also do OB because there are fewer of them and it's so regional.

If it's not about the money for you, then a difference of $50K shouldn't matter too much. In the end, when you factor in liability, it is probably a wash, if your FP practice includes nearly as many deliveries and procedures as an OBGYN would.

We are now officially off topic on this thread...

 

[fmdoc]

I appreciate your reply and wish you all the best! I personally like fm, but i am in love with ob/gyn! I met a former ob/gyn practicing physician in the US who was doing his fm residency...and he is around 50 yo and a fmg! He told me he had enough of ob/gyn...he wanted a different lifestyle...So, my opinion is that you should think about what you would be comfortable doing in the medical field when you are 50 yo and on! Thanks again and good luck!

 

[sophiejane]

I appreciate your reply and wish you all the best! I personally like fm, but i am in love with ob/gyn! I met a former ob/gyn practicing physician in the US who was doing his fm residency...and he is around 50 yo and a fmg! He told me he had enough of ob/gyn...he wanted a different lifestyle...So, my opinion is that you should think about what you would be comfortable doing in the medical field when you are 50 yo and on! Thanks again and good luck!

Isn't that the truth?!

The grass is always greener on the other side...and apparently that side changes as you get older...

Maybe the moral of the story is to do FP with an OB fellowship after all--to retain maximum flexibility!

Good luck to you too!

 

[Diane L. Evans]

Isn't that the truth?!

The grass is always greener on the other side...and apparently that side changes as you get older...

Maybe the moral of the story is to do FP with an OB fellowship after all--to retain maximum flexibility!

Good luck to you too!

Unfortunately with the OB malpractice FP c OB fellowship may not be they way to go. You get the same malpractice rates if doing OB as a FP and the volume isn't ther to justify this. Also there are instances where you still would need an OB for backup. FYI I know several FP's that are now in OB residencies because of this...

 

[daisyduke]

If you find yourself this drawn to OB/GYN... then go for it!!! Sounds like you really love it... I think you will regret not choosing it!

If you are concerned about matching in OB/GYN in Texas as a DO, then start looking into visiting electives at the programs you are interested in. Most programs start taking applications for visiting Sub-I's in the spring. Contact the schools and ask about their application process so you can collect all the necessary components (letters from your school, appropriate vaccinations/titers, transcripts) and have them ready for the spring. Doing an elective will definitely get your foot in the door at an allopathic program!

Good luck! Do OBGYN!!!

 

[sophiejane]

Unfortunately with the OB malpractice FP c OB fellowship may not be they way to go. You get the same malpractice rates if doing OB as a FP and the volume isn't ther to justify this. Also there are instances where you still would need an OB for backup. FYI I know several FP's that are now in OB residencies because of this...

I'm pretty well aware of the malpractice situation, and I'm doing my homework on the issue in my area. It's very regional. The town where I did my rural FP rotation had only FPs and no OBGYNs and they were delivering lots of babies and doing very well. There were OBs in the next bigger town over, but they generally just sent them the high riskers. Just depends on where you are.

Obviously, I am considering abandoning the idea of an FP OB fellowship or I wouldn't be here...

Just trying to get some different perspectives on the options. Thanks for your responses!

 

[sophiejane]

If you find yourself this drawn to OB/GYN... then go for it!!! Sounds like you really love it... I think you will regret not choosing it!

If you are concerned about matching in OB/GYN in Texas as a DO, then start looking into visiting electives at the programs you are interested in. Most programs start taking applications for visiting Sub-I's in the spring. Contact the schools and ask about their application process so you can collect all the necessary components (letters from your school, appropriate vaccinations/titers, transcripts) and have them ready for the spring. Doing an elective will definitely get your foot in the door at an allopathic program!

Good luck! Do OBGYN!!!

Thanks, Daisy. Sounds like a good plan. My school only allows us to do 2 4th year electives in the same field and there are 4 programs that I really want to show my face at. I can do subspecialties at the other 2, just not straight up OBGYN. What would you suggest? I thought Gyn Onc might be a good one, and maybe Uro Gyn. Should I do the subspecialty rotations at my top 2 choices, or inpatient L&D? I definitely would feel I could "show off" more just doing inpatient and general clinic rotation, since that has been the bulk of my experience so far, but then, I might get more face time with the attending on a subspecialty rotation...??

 

[daisyduke]

Should I do the subspecialty rotations at my top 2 choices, or inpatient L&D? I definitely would feel I could "show off" more just doing inpatient and general clinic rotation, since that has been the bulk of my experience so far, but then, I might get more face time with the attending on a subspecialty rotation...??

sophiejane- My suggesetion is to do whatever away elective you are able to arrange... sometimes there aren't too many spots available for visiting students, so take what you can get! It is hard to say if doing a subspecialty vs. a general rotation would be better. If the subspecialty at the institution has a corresponding fellowship, you might end up mainly working with the residents and the fellows and not as much with attendings. But, if you do say a Gyn Onc rotation where there aren't fellows, you will get more face time with staff. I think you should do the rotation you are most interested in! If you aren't working enough with the faculty, you can set up additional meetings with them so they can get to know you. If you do a non-ObGyn rotation at an instituion, maybe you can also set up a meeting with the PD there to express your interest and introduce yourself. Good luck!

 

[Stephanieukmed]

Having just been in a similar situation not long ago I can sympathize. I did OB last my 3rd year, and until then was all set to do general surgery. After I made the switch, I had to completely re-do my 4th year schedule. Long story short it has all worked out fine.
My advice for you extramurals is to look and see what division the PD is in at the places you want to go (I found that a lot were MFM's) and do rotations in that division. Also, and this is just in my personal experience, not many places have just general obgyn rotations, so that may save you some headaches.
Take a look at Texas Tech, one of my friends who is a private obgyn went to med school there and loved it.

 

[gyngirl06]

sophiejane, I just wanted to add that you can probably get away with doing more than 2 electives in ob/gyn in your 4th year. My school has the same restriction about no more than 2 in one field, but maternal-fetal, reproductive endocrinology, urogyn, etc, probably can all count as different fields. I did gyn surgery, family planning, and outpatient women's health...

Having just been in a similar situation not long ago I can sympathize. I did OB last my 3rd year, and until then was all set to do general surgery. After I made the switch, I had to completely re-do my 4th year schedule. Long story short it has all worked out fine.
My advice for you extramurals is to look and see what division the PD is in at the places you want to go (I found that a lot were MFM's) and do rotations in that division. Also, and this is just in my personal experience, not many places have just general obgyn rotations, so that may save you some headaches.
Take a look at Texas Tech, one of my friends who is a private obgyn went to med school there and loved it.